Development and changing trend in monitoring of healthcare-associated in-fection in China / 中国感染控制杂志

Objective To summarize the effectiveness in monitoring activities for healthcare-associated infection (HAI)in China in the past 30 years,explore the changing trend in HAI monitoring,find a new model for the moni-toring of HAI in China.Methods A total of 194 comprehensive hospitals and military hospitals in 13 provinces (au-tonomous regions,municipalities)were selected,questionnaire survey was adopted to investigate the situation of HAI monitoring.Results Of 194 hospitals,184 (94.85%)had available data after being checked,incidence of HAI in secondary and tertiary hospitals were 0.78% and 1.58% respectively,difference was significant (P <0.01).Monitoring was divided into two stages,cumulative percentage of each monitoring activity before 2006 and during 2006-2016 were respectively as follows:environmental hygiene were 73.91% and 100.00%,disinfection ef-ficacy 69.57% and 97.28%,overall comprehensive monitoring 64.67% and 98.91%,surgical site infection(SSI) 13.04% and 94.57%,ICU HAI 4.89% and 87.50%,neonatal HAI 1.75% and 60.82%,multidrug-resistant or-ganisms(MDROs)5.43% and 95.65%,hand hygiene compliance 2.17% and 93.48%,antimicrobial agents 15.22% and 87.50%.The reporting rate of HAI outbreak in tertiary hospitals was higher than secondary hospitals (33.33% [n=37]vs 16.44%[n=12],P =0.01).Conclusion The monitoring of HAI in China starts late,but develops rapidly,defects still exist in HAI monitoring system,reporting rate of HAI cases is still high,reporting rate of HAI outbreak is low.

Prevention and control of catheter-associated urinary tract infection in China / 中国感染控制杂志

Objective To realize the current situation of prevention and control of catheter-associated urinary tract infection (CAUTI)since the development of healthcare-associated infection(HAI)management in China in the re-cent 30 years.Methods Random cluster sampling was used to select 165 secondary and tertiary hospitals in 13 provinces and cities in China,questionnaires were filled in,the content included time,scope,method,data feed-back,and incidence of CAUTI monitoring.Results Of 165 hospitals,92.12% (152/165)have implemented targe-ted monitoring,the implementation rate in tertiary hospitals was higher than secondary hospitals (98.08% [102/104]vs 81.97%[50/61],χ2 =13.748,P <0.001).Most hospitals (82.24%[125/152])only implemented monito-ring in intensive care units(ICUs)or partial ICUs.HAI management professionals,HAI control doctors and nurses in 69.08%(105/152)of hospitals jointly took responsibility for CAUTI monitoring.95.39% (145/152)of hospitals diagnosed CAUTI by combination of clinical manifestations and laboratory examination results.98.68%(150/152) of hospitals have gradually implemented intervention measures,such as strictly mastering the indications of urinary indwelling catheters,hand hygiene of health care workers,non-frequent change of urinary indwelling catheters,and necessity for daily assessment of catheterization.75.66% (115/152)of hospitals conducted feedback of monitored results to the whole hospital.Incidences of CAUTI in pre-2010,2010,and 2015 were 3.10‰,4.72‰,and 1.89‰respectively.Conclusion In the recent 30 years,monitoring on CAUTI in China has obtained achievement,CAUTI monitoring is gradually standardized and scientific,but the development at all levels of medical institutions is still imbalance,which needs to be improved further.

Occupational exposure and protection among health care workers in China / 中国感染控制杂志

Objective To understand the current situation of occupational exposure and protection among health care workers (HCWs ), and provide evidence for formulating preventive measures of occupational exposure. Methods From April 6,2016 to May 6,2016,questionnaire surveys were conducted in 158 different levels of hos-pitals in 13 provinces in China,occupational exposure,protection management,and monitoring of occupational expo-sure in the first year,2010,and 2015 was surveyed by cluster random sampling method.Results Occupational ex-posure in 81.65% (129/158)of hospitals was responsible by healthcare-associated infection management depart-ments;98.73%(156/158)of hospitals set up the relevant rules and regulations;77.22%(122/158)of hospitals had missing report of occupational exposure.A total of 11 116 times of occupational exposure occurred (1 542 cases in the first year,2 474 in 2010,and 7 100 in 2015).Of various types of occupational exposure,sharp injury accounted for 96.76%;among HCWs sustained occupational exposure,nursing staff accounted for 53.90%;the major de-partment that HCWs who sustained occupational exposure were general wards,operating rooms,and intensive care units;the main medical appliances related to occupational exposure were syringes,scalp needles,and surgical suture needles;high-risk behavior causing occupational exposure were intravenous injection,putting needles into the sharp con-tainers,and surgical suturing;among occupational exposure sources,HBV accounted for 58.69%.Conclusion HCWs in China face a high risk of occupational exposure,occurrence of occupational exposure should be reduced through gov-ernment legislation,application of safety appliances,standardizing behavior of HCWs,proper using of personal pro-tective equipment,strengthening education and training of HCWs,and establishing a sound occupational exposure report,evaluation and follow-up system.

Economic loss due to healthcare-associated infection in 68 general hospitals in China / 中国感染控制杂志

Objective To explore the direct economic loss caused by healthcare-associated infection(HAI)in general hospitals in China.Methods 68 hospitals were selected,a retrospective 1:1 matched survey was conducted to compare the direct medical cost in patients with and without HAI between January 1,2015 and December 31,2015. Results A total of 2 123 pairs of patients with and without HAI were included in the survey.The average cost of hospitalization in HAI and non-HAI groups were ￥25 845.30 and ￥12 006.14 respectively,￥13 839.16 on average was increased due to HAI.The average economic loss in provincial and ministerial levels of hospitals were￥21 409.83.The average economic loss in different regional hospitals were ￥9 725.42-￥18 909.59,and north China ranked the first.Economic loss caused by bloodstream infection and lower respiratory tract infection were more than other sites,which were ￥23 190.09 and ￥18 194.50 respectively.Conclusion HAI resulted in considerable direct economic loss.Prevention and control of HAI,especially bloodstream infection and lower respiratory tract infection should be paid more attention.

Awareness of hand hygiene knowledge and compliance status in Chinese hospitals / 中国感染控制杂志

Objective To understand the status of awareness of hand hygiene(HH)knowledge and compliance among health care workers (HCWs)in China,and provide scientific basis for further improvement of HH practice. Methods A multi-centre retrospective survey on awareness of HH knowledge and compliance was conducted in 200 nationwide hospitals in 2015.Results The awareness rates of HH methods and HH indications among HCWs were 86.5% and 82.5% respectively;cleaning staff had the lowest awareness rate of HH indications(69.9%),followed by the other interns and advanced-study students (70.2%),as well as medical technicians (79.8%);attendants had the lowest awareness rate of HH methods(76.9%),followed by advanced-study students and interns(81.0%),and cleaning staff (82.4%);HH knowledge awareness rate among HCWs in secondary hospitals was lower than tertia-ry hospitals,and the district-level hospitals had the lowest awareness rate of HH.HH compliance rate and correct rate were 70.1% and 74.9% respectively;the interns and advanced-study students were at a low level of compliance and correct rates (61.4% and 60.9% respectively);the municipal hospitals had the lowest compliance and correct rates,non-teaching hospitals were lower than teaching hospitals.Conclusion HH in primary hospitals is weak,HH of interns,advanced-study students,as well as attendants and cleaning staffs are not enough,HH management should be strengthened,awareness and compliance of HH should be improved.

Study on intervention in central line-associated bloodstream infection in intensive care units / 中国感染控制杂志

Objective To evaluate the effect of evidence-based bundle intervention strategy on reducing the inci-dence of central line-associated bloodstream infection (CLABSI).Methods Prospective and multicenter study was adopted,patients admitted to 54 intensive care units (ICUs)of 41 hospitals and with central venous catheters (CVCs)between October 1 ,2013 and September 30,2014 were monitored .Baseline data between October 2013 and March 2014 were collected as pre-intervention data;from April to September 2014,the participated hospitals performed intervention strategy,post-intervention data were compared with pre-intervention data.Results The usage rate of CVCs before and after intervention was significantly different (44.18% vs 44.63%,χ2 =5.526,P =0.019).Incidence of CLABSI before and after intervention was not significantly different(RR ,0.82[95%CI ,0.59-1 .13],P =0.10).Constituent ratio of catheter insertion sites between pre-and post-intervention was significantly different (χ2 =76.264,P <0.001),femoral vein catheterization rate as well as proportion of two and above catheter insertion sites after intervention decreased(17.25% VS 13.72%;2.27% VS 1 .44%,respectively);hand hygiene implementation rate and accuracy rate after intervention were both higher than before intervention (79.73% vs 76.14%,P <0.001 ;91 .47% vs 74.26%,P <0.001 ,respectively);constituent ratio of skin disinfectant applica-tion before and after intervention was significantly different(χ2 =3.861 ,P <0.001 ),proportion of chlorhexidine ethanol increased (29.62% VS 50.56%);except daily assessment and record,compliance to other prevention and control measures before and after intervention were all significantly different(all P <0.001);utilization rate of max-imal sterile barrier,qualified rate of dressing of operators,and port disinfection were all significantly enhanced. Conclusion Bundle intervention in intubation and maintenance are implemented effectively,but intervention effect on CLABSI needs further study.

Effectiveness of multicenter intervention in hand hygiene compliance among health care workers in intensive care units / 中国感染控制杂志

Objective To evaluate the effect of comprehensive intervention measures on improving hand hygiene (HH)compliance of health care workers(HCWs)in intensive care units (ICUs)by multicenter study.Methods A total of 47 hospitals in 12 provinces and cities were enrolled in the study,from October 2013 to September 2014, HH compliance among HCWs in ICUs was investigated according to World Health Organization HH investigation method,HH compliance rates before and after intervention were compared.Results HH compliance rate of HCWs in ICUs increased from 73.70%(11 155/15 135)before intervention to 78.70%(18 206/23 132)after intervention (χ2 =128.16,P <0.01);except northeast region ,HH compliance of HCWs in the other provinces increased signif-icantly after intervention(all P <0.05);among all departments,HH compliance of HCWs in general ICUs,respira-tory ICUs,emergency ICUs,and surgical ICUs increased significantly(all P <0.05);HH compliance of HCWs of all kinds of occupations increased significantly(all P <0.05);HH compliance rates before touching a patient,before clean/aseptic procedure,after touching a patient,and after touching patient surroundings increased significantly after intervention(all P <0.01 ).Conclusion Comprehensive interventions are helpful for improving HH compliance of HCWs in ICUs. Objective To evaluate the effect of comprehensive intervention measures on improving hand hygiene (HH)compliance of health care workers(HCWs)in intensive care units (ICUs)by multicenter study.Methods A total of 47 hospitals in 12 provinces and cities were enrolled in the study,from October 2013 to September 2014, HH compliance among HCWs in ICUs was investigated according to World Health Organization HH investigation method,HH compliance rates before and after intervention were compared.Results HH compliance rate of HCWs in ICUs increased from 73.70%(11 155/15 135)before intervention to 78.70%(18 206/23 132)after intervention (χ2 =128.16,P <0.01);except northeast region ,HH compliance of HCWs in the other provinces increased signif-icantly after intervention(all P <0.05);among all departments,HH compliance of HCWs in general ICUs,respira-tory ICUs,emergency ICUs,and surgical ICUs increased significantly(all P <0.05);HH compliance of HCWs of all kinds of occupations increased significantly(all P <0.05);HH compliance rates before touching a patient,before clean/aseptic procedure,after touching a patient,and after touching patient surroundings increased significantly after intervention(all P <0.01 ).Conclusion Comprehensive interventions are helpful for improving HH compliance of HCWs in ICUs.

Multicenter study on epidemiology of device-associated infection in neonatal intensive care units / 中国感染控制杂志

Objective To investigate the epidemiological characteristics of device-associated infection (DAI)in neonatal intensive care units(NICUs)of tertiary first-class hospitals in China,and provide scientific evidence for the prevention and control of neonatal DAI.Methods Neonates in NICUs at 17 hospitals of 9 provinces from October 2013 to September 2014 were selected for multicenter study,DAI was surveyed prospectively according to the uni-form diagnostic criteria and methods.Results A total of 12 998 neonates were monitored,the total patient-days were 126 125 d,13 cases of central line-associated bloodstream infection (CLABSI)and 70 cases of ventilator-asso-ciated pneumonia (VAP)occurred,central line utilization rate was 15.56%,incidence of CLABSI was 0.66/1 000 device-days;ventilator utilization rate was 7.67%,incidence of VAP was 7.23/1 000 device-days.Utilization rates of central line and respirator in neonates with body weight ≤ 1 000 g was the highest,which were 61 .06% and 29.91 % respectively;In NICUs with 20-30 beds,utilization rate of central line was the highest(16.67%),and res-pirator was the lowest(4.11 %);of hospitals in different regions,central line and respirator utilization rate in south-west China was the highest.Of different sizes of ICUs,VAP per 1 000 device-days was the lowest in NICUs with 20-30 beds(2.36 ‰).Difference in incidence of CLABSI and VAP per 1 000 device-days in neonates at NICUs of different regions were significantly different;incidence of CLABSI and VAP per 1 000 device-days was highest in southern China(2.68 ‰ and 31 .06‰ respectively),followed by southwest region.Of different quarters,incidence of CLABSI,and VAP per 1 000 device-days were not significantly different(all P >0.05).Conclusion Device utili-zation rate and incidence of DAI in China are both high,and are different in neonates of different birth weight,at different sizes of NICUs,as well as different regions,monitoring should be intensified,prevention and control measures should be implemented according to infection characteristics.

Risk factors of healthcare-associated infection in patients with craniocere-bral operation / 中国感染控制杂志

Objective To investigate risk factors for healthcare-associated infection(HAI)in patients with craniocerebral operation,and provide reference for the prevention and control of HAI.Methods A total of 4 246 cases of craniocerebral surgery in a neurosurgery department from January 2010 to December 2012 were enrolled in the study,the risk fac-tors for HAI were analyzed.Results Of 4 246 cases of craniocerebral surgery,393 patients developed 446 times of post-operative HAI,HAI incidence rate was 9.26%,case infection rate was 10.50%,which were higher than inci-dence (2.02%)and case infection rate (3.02%)of HAI of all hospital during the same period,the difference was statistically significant (χ2 =811 .06,629.30,respectively,P 7 d,antimicrobial use >7 d,central venous and urinary tract cathe-terization,invasive ventilator were risk factors for HAI in patients with craniocerebral operation.Conclusion The incidence of HAI in patients with craniocerebral operation is high,effective preventive and control measures accord-ing to risk factors should be strengthened to reduce the incidence of HAI.

Prevalance of HIV Infection in Hospitalized Patients and Prevention Measures / 中华医院感染学杂志

OBJECTIVE To understand the prevalence of HIV infection in hospitalized patients and the prevention measures.METHODS The prevalence of HIV infection of the hospitalized patients in our General Hospital from Jan 2005 to Jun 2009 was investigated retrospectively.The time,population and endemic distribution of the HIV infected patients were analyzed.RESULTS Forty-eight HIV infected patients(19 HIV patients),were screened out from 271 955 hospitalized patients from Jan 2005 to Jun 2009 with year by year increasing.Most of HIV infected patients(62.5%) came from Beijing,Henan and Hebei provinces.Some sporadic patients came from other areas.CONCLUSIONS The prevalence of HIV infected patients among hospitalized patients in our hospital is increasing in recent years.The prevention measures in diagnosis and therapy process for these patients should be strengthened to reduce hospital infection.

Designing Scientific Designin Hospital Construction / 中华医院感染学杂志

OBJECTIVE In order to prevent and control the nosocomial infection effectively by hospital construction design scientifically.METHODS The theory and the practical application of hospital construction,were analyzed and discussed to prevent the nosocomial infection.RESULTS The hospital construction was fundamental in preventing and controlling nosocomial infection.It could control exogenous nosocomial infection.Through scientific and effective isolation,the hospital construction could help to control source of infection,cut off infection routin and protect the susceptible population.CONCLUSIONS Hospital construction design should conform to the principle of nosocomial infection precention and control.

Analysis of Air Concentration of Aspergillus Flavus in Hospital / 中华医院感染学杂志

OBJECTIVE To study the degree and regular of Aspergillus flavus air contamination in hospital.METHODS Some ambient air of different environment in our hospital was taken 5 times in one day of four seasons one year by using centrifugal air sampler,and then cultivated(using eumycete cultural methods),counted and analyzed.RESULTS A.flavus strain was collected in all sampling points in four seasons.The concentration of Aspergillus flavus in six standort was diverse from each other,and the highest was the out-patient clinic with 1238.9 CFU/m3.The concentration of Aspergillus flavus in each division of Medical Department was significant difference during four seasons(P0.05).The difference between internal medicine and external enviroment was significant between the first and the third season(P=0.022,P=0.039),but that of the second and the fouth season was not significant(P=0.022,P=0.624).CONCLUSIONS The contamination of Aspergillus flavus in hospital was severe.So it′s necessary to prevent the Aspergillus flavus infection and enhance the environmental control of susceptible population.

Nanometer Photocatalysis Air Disinfector and Its Application / 中华医院感染学杂志

OBJECTIVE To explore the effect of the nanometer photocatalysis air disinfector.METHODS The air disinfection effect of nanometer photocatalyis air disinfectior JBL-400 series,such as the self-cycling movable,mosaic and attached to the wind gap air disinfectors,was detected in the simulating field trial and field trial in intensive care units,operating rooms and therapy rooms according to the Disinfection Technique Standards.RESULTS The kill ratio of self-cycling air disinfector in simulating trial was more than 99.9%.After constant air disinfection in the above three kinds of medical divisions,the total bacteria number of static state in these places could reach to the standard of area Ⅱ(≤200 CFU/m3),with 56.8-78.4% dissolution ratio of the natural bacteria.The total bacteria number of dynamic state in these places could reach to the standard of area Ⅱ or area Ⅲ.CONCLUSIONS The JBL-400 series air disinfector has diverse application forms,and disinfects quickly with good effects.It can be used in all kinds of medical divisions.

Nature of Moral Environment of Higher Educational Institutes and Its Theoretical Features / 中国医学伦理学

The ecological environment of medical ethics education is an ecological environment for the moral development of college students,mainly including human environment,material environment,dynamic environment,and cultural environment,etc.Its most dramatic feature is the ecological feature,and the morality feature is its most outstanding one.

A Reflection on Enhancing the Teaching Effect of Ideological and Moral Cultivation / 中国医学伦理学

In order to enhance the teaching effect of ideological and moral cultivation,the teaching staff should strengthen their consciousness of exploring truth,being enterprising and a role model for students.During the teaching process,great attention should paid to the pertinence of teaching preparation,the diversity of teaching modes,the practicality of assignment,and the ideological characteristics of assessment setting,so that college students could be cultivated to be qualified socialist constructors with grand ideals,noble morality,fine culture and strict disciplines.

An Analysis of the Forming Process of Medical Ethics among Medical Students / 中国医学伦理学

The formation of medical ethics among medical students is an individual process of recognizing,selecting,and modifying medical ethics,a process from ignorance,to consciousness,and finally to responsible self-consciousness for the main body of medical ethics,a process to manifest individual liberty of medical ethics,independence of medical ethics,and pursue the progress of medical ethics,and also a process to combine recognition and practical behaviors,and realize the mutual transformation of internal and external medical ethics.

Disinfection Effect of Acidity Electrolyzed Oxidizing Water:An Experimental Study / 中华医院感染学杂志

OBJECTIVE To confirm the clinical disinfection effect of acidity electrolyzed oxidizing water(AEOW).METHODS According to the standards of disinfection techniques supplied by Health Ministry of China,the disinfection effect of health care worker,object surfaces and medical apparatus and instrument were investigated.RESULTS The log reduction of the bacteria on the hands,object surfaces and medical instruments were more than 1.00.The number of the bacteria on the endoscopes were 0-2 CFU per piece on average.No pathogenic bacteria were detected out.The disinfection effect of each experimental group was qualified.CONCLUSIONS The field disinfection effect of AEOW is accepted.